The Supreme Court in March devoted three days of oral arguments to the reform law, the sprawling 906-page act of Congress (PDF) that sought to accomplish dozens of goals, including expanding insurance coverage by 32 million people, preventing insurers from discriminating against the sick and offering coverage through state-run insurance exchanges. The law passed entirely with votes from Democrats.
Although Barack Obama said during his 2008 election campaign that he opposed a mandate for Americans to purchase insurance, the final law he signed included just such a requirement. The individual mandate has since become the main legal stumbling block to implementation of the law.
Obama, a former constitutional law professor, has argued that the mandate is a constitutional exercise of Congressional power under past Supreme Court precedents. But opponents, including 26 state governments, say the Constitution's Commerce Clause has never given federal lawmakers the right to regulate a decision not to enter commerce or to force Americans to buy a product for the purpose of regulating them.
The court has four specific questions before it: Does it have jurisdiction to hear the case before 2014? Is the individual mandate legal? If the mandate is illegal, should the rest of the reform law be struck down? And is the law's expansion of state Medicaid programs legal?